Intro Regulation of K+,Pi,Mg2+, Ca2+ Flashcards

1
Q
  • Normal ranges for plasma K+
A

3.5-5.0 mEq/L

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2
Q
  • K+ distribution in the body
A
  • 98% Intracellular
    • 80% muscle cells (~150 mEq/L)
    • 20% Other cells
  • 2% Extracellular (3.5-5.0 mEq/L)
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3
Q
  • What accounts for the 30 fold difference between intracellular K+ and extracellular K+ concentrations?
A
  • Na+-K+ ATPase
  • NaK2CL (NKCC)
  • K+ channe;s
  • Transcellular distribution regulated by other factors (ie: hormones)
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4
Q
  • Define Hypokalemia
  • What causes it?
A
  • K+ < ~3.7 mE/L
  • Caused by:
    • Vomiting/diarrhea
    • Insulin excess
    • Deficiency
    • Alkalosis
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5
Q
  • Define Hyperkalemia
  • What can cause it?
A
  • [K+] > 5.2 mEq/L
  • Lethal if > 10 mEq/L
  • Causes
    • Excessive intake
    • Tissue release (burns, hemolysis, rhabdomyolysis)
    • Shifts from ICF to ECF (acidosis, insulin deficiency, tissue damage, hyperglycemia)
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6
Q
  • Define Pseudohyperkalemia
  • What causes it?
A
  • Artificially high [K+]
  • Lysis of RBCs during blood draw
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7
Q
  • Major routes of K+ loss from the body
A
  • Feces
  • Urine
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8
Q
  • What is the effect of hyperkalemia on cardiac muscle cells?
  • What is the effect of hyperkalemia on other cells?
A
  • Hyperpolarizes membrane (bradycardia, ELEVATED T wave, less likely to fire AP)
  • Hypopolarizes cell (makes it easier to reach threshold and fire AP)
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9
Q
  • What is the effect of hypokalemia on cardiac cells?
  • What is the effect of hypokalemia on other cells?
A
  • Hypopolarizes cell (tachycarida, low T wave)
  • Hyperpolarization
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10
Q
  • How much Ca2+ do we need per/day?
A

1000 mg

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11
Q
  • How is the body calcium pool supplied?
A
  • GI reabsorption via calcitriol
  • Bone resorption via PTH and Calcitriol
    *
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12
Q
  • How is Ca2+ from the body Ca2+ pool removed?
A
  • Secretion into the GI tract
  • Excretion via the kidneys
  • Deposition in bone via calcitonin
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13
Q

Hypocalcemia _ neuromuscular excitability

A
  • Increases neuromuscular excitability
  • Why you can see hypocalcemic tetany/spasticity
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14
Q
  • Hypercalcemia _ neuromuscular excitability
A
  • Decreases
  • Threshold shifts away from RMP (hyperpolarizes)
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15
Q
  • Regulators of Ca2+
A

PTH, Calcitonin, Calcitriol

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16
Q
  • What can cause elevated serum Ca2+?
A
  • Primary hyperparathyroidism (lots of PTH secreted)
  • Malignancy
17
Q
  • What can cause low serum Ca2+?
A
  • Hypoparathyroidism
  • Renal Disease
  • Vitamin D Deficiency
18
Q
  • What is the required dietary intake of phosphorus?
A
  • ~1500 mg/day
19
Q
  • Where are the body pools for phosphorus located?
A
  • 85%-BONE
  • 14% cells
  • 1% serum
20
Q
  • How are body pools of phosphorus lost?
A
  • Bone deposition
  • Stool
  • Urine
21
Q
  • What are the four main regulators of phosphate metabolism?
A
  1. Dietary- phosphate intake and absorption
  2. Calcitriol- increases resorption from bone and absorption from intestine (increases body pool of phosphorus)
  3. PTH- resorption from bone directly, intestinal absorption thru stimulation of calcitriol production
  4. Renal tubular- reabsorption of phosphorus (Stimulated by tubular filtered load of phosphorus and inhibited by PTH)
22
Q
  • Where is calcitriol produced?
A
  • Kidneys
23
Q
  • Where is Mg2+ stored in the body?
A
  • 50% in bone
  • 49% ICF (Especially muscle)
  • 1 % ECF
24
Q
  • What important cellular functions does Mg2+ play a role in?
A
  • Nucleotide binding
  • Enzymatic cofactor
  • Glycolysis
  • Proliferation
25
Q
  • Mg2+ depletion is associated with what conditions?
A
  • Migraine
  • Depression
  • Epilepsy
  • SIDS
  • Arrythmia
  • Preeclampsia
  • Muscle Cramps
26
Q
  • What is normal TOTAL serum Mg2+?
  • What is a normal FREE serum Mg2+?
A
  1. 8-2.2 mEq/L
  2. 8-1.0 mEq/L
27
Q
  • Total Mg2+ consists of
  • What is the most abundant
A
  • Ionized Mg2+
  • Diffusible Mg2+ complexes
  • Nondiffusible (protein-bound) Mg2+
  • Ionized Mg2+